B-119717, MAY 19, 1954, 33 COMP. GEN. 560

B-119717, MAY 19, 1954, 33 COMP. GEN. 560

PANAMA CANAL COMPANY - SEAMEN EMPLOYEES - ENTITLEMENT TO FREE MEDICAL CARE - REIMBURSEMENT OF COST OF MEDICAL CARE TO PUBLIC HEALTH SERVICE SECTION 322 (A) (3) OF THE PUBLIC HEALTH SERVICE ACT PROVIDES THAT THE PUBLIC HEALTH SERVICE SHALL FURNISH CIVILIAN SEAMEN MEDICAL, SURGICAL, AND DENTAL TREATMENT AND HOSPITALIZATION WITHOUT CHARGE WHEN EMPLOYED ON GOVERNMENT VESSELS OF MORE THAN FIVE TONS BURDEN, AND THEREFORE EMPLOYEES OF THE PANAMA CANAL COMPANY FALLING WITHIN THE PURVIEW OF SECTION 322 (A) (3) OF THE ACT ARE ENTITLED TO THE MEDICAL AND RELATED BENEFITS PROVIDED THEREIN AND THERE IS NO REQUIREMENT THAT THE COMPANY REIMBURSE THE PUBLIC HEALTH SERVICE FOR SUCH SERVICES, NOTWITHSTANDING THE GOVERNMENT AGENCY REIMBURSEMENT PROVISIONS OF SECTION 252 OF THE CANAL ZONE CODE. SECTION 106 OF THE CIVIL FUNCTIONS APPROPRIATION ACT, 1954, WHICH PROHIBITS THE USE OF FUNDS OF THE PANAMA CANAL COMPANY OR THE CANAL ZONE GOVERNMENT AFTER DECEMBER 31, 1953, TO PROVIDE FREE MEDICAL AND HOSPITAL CARE FOR EMPLOYEES OF THOSE TWO AGENCIES, OPERATES TO PRECLUDE THE USE OF CANAL COMPANY FUNDS TO REIMBURSE THE PUBLIC HEALTH SERVICE FOR MEDICAL OR HOSPITAL CARE FURNISHED CANAL COMPANY EMPLOYEES (SEAMEN) COVERED BY THE PUBLIC HEALTH SERVICE ACT WITHOUT AFFECTING THE RIGHTS OF SUCH EMPLOYEES TO BENEFITS GRANTED BY THE ACT.

ACTING COMPTROLLER GENERAL WEITZEL TO THE GOVERNOR, CANAL ZONE GOVERNMENT, MAY 19, 1954:

REFERENCE IS MADE TO LETTER OF APRIL 13, 1954, FROM THE VICE PRESIDENT, THE PANAMA CANAL COMPANY, REQUESTING A DECISION RELATING THE THE MEDICAL CARE AND HOSPITALIZATION FURNISHED SEAMEN, EMPLOYED BY THE PANAMA CANAL COMPANY.

THE FIRST QUESTION PRESENTED IS WHETHER, IN THE ABSENCE OF SECTION 106, CIVIL FUNCTIONS APPROPRIATION ACT, 1954, 67 STAT. 197, 202--- WHICH PROHIBITS THE USE AFTER DECEMBER 31, 1953, OF FUNDS OF THE PANAMA CANAL COMPANY OR THE CANAL ZONE GOVERNMENT, FOR PROVIDING FREE MEDICAL AND HOSPITAL CARE TO EMPLOYEES OF THOSE TWO AGENCIES--- SECTION 252 OF THE CANAL ZONE CODE (ACT OF JUNE 29, 1948, 62 STAT. 1075, 1080) WOULD REQUIRED REIMBURSEMENT FROM THE CANAL ZONE COMPANY TO THE PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE FOR MEDICAL CARE AND HOSPITALIZATION FURNISHED THE CANAL COMPANY'S SEAMEN UNDER SECTION 322 OF THE PUBLIC HEALTH SERVICE ACT, 58 STAT. 683.

THE SECOND QUESTION IS WHETHER THE SAID SECTION 106 OPERATES MERELY TO PRECLUDE THE USE OF CANAL COMPANY FUNDS TO REIMBURSE THE PUBLIC HEALTH SERVICE FOR MEDICAL OR HOSPITAL CARE FURNISHED TO CANAL COMPANY EMPLOYEES COVERED BY THE PUBLIC HEALTH SERVICE ACT WITHOUT AFFECTING THE RIGHTS OF SUCH EMPLOYEES TO BENEFITS GRANTED BY THE ACT, OR WHETHER SECTION 106 MAY BE REGARDED AS AMENDING THE PUBLIC HEALTH SERVICE ACT SO AS TO DISENTITLE SEAMEN EMPLOYEES OF THE PANAMA CANAL COMPANY FROM BENEFITS THERETOFORE ENJOYED.

THE QUESTIONS WILL BE CONSIDERED IN THE ORDER PRESENTED.

SECTION 322 (A), 58 STAT. 696, OF THE PUBLIC HEALTH SERVICE ACT REFERRED TO ABOVE PROVIDES IN PART:

THE FOLLOWING PERSONS SHALL BE ENTITLED, IN ACCORDANCE WITH REGULATIONS, TO MEDICAL, SURGICAL, AND DENTAL TREATMENT AND HOSPITALIZATION WITHOUT CHARGE AT HOSPITALS AND OTHER STATIONS OF THE SERVICE:

(3) SEAMEN, NOT ENLISTED OR COMMISSIONED IN THE MILITARY OR NAVAL ESTABLISHMENTS, WHO ARE EMPLOYED ON STATE SCHOOL SHIPS OR ON VESSELS OF THE UNITED STATES GOVERNMENT OF MORE THAN FIVE TONS' BURDEN;

AS DEFINED IN THE PUBLIC HEALTH SERVICE REGULATIONS, 42 CFR 32.1 (D), THE TERM "SEAMEN" INCLUDES ANY PERSON EMPLOYED ON BOARD IN THE CARE, PRESERVATION, OR NAVIGATION OF ANY VESSEL, OR IN THE SERVICE, ON BOARD, OF THOSE ENGAGED IN SUCH CARE, PRESERVATION, OR NAVIGATION. THE BENEFITS CONFERRED BY THE PUBLIC HEALTH SERVICE ACT UPON EMPLOYEES WHO QUALIFY AS SEAMEN UNDER THE COVERAGE PROVISIONS OF THE ACT ACCRUE TO THEM AS INDIVIDUALS BECAUSE OF THEIR OCCUPATION STATUS AND NOT BECAUSE THEY ARE EMPLOYEES OF ANY PARTICULAR DEPARTMENT, AGENCY, OR CORPORATION OF THE GOVERNMENT, OR PRIVATE CORPORATION, OR OWNER OF ANY VESSEL. SECTION 252 OF THE CANAL ZONE CODE REQUIRES THAT THE PANAMA CANAL COMPANY REIMBURSE CERTAIN NAMED AGENCIES FOR CERTAIN SPECIFIED CONTRIBUTIONS AND PAYMENTS, AND ALSO TO REIMBURSE OTHER GOVERNMENT AGENCIES FOR ANY PAYMENTS OF A NATURE SIMILAR TO THOSE SPECIFIED, MADE ON BEHALF OF THE CANAL COMPANY. THE MEDICAL AND RELATED SERVICES FURNISHED SEAMEN UNDER THE PUBLIC HEALTH SERVICE ACT ARE NOT PAYMENTS WITHIN THE PURVIEW OF SECTION 252; NEITHER ARE SUCH SERVICES RENDERED ON BEHALF OF THE CANAL COMPANY. THE RENDITION OF SUCH SERVICES ARE EXCLUSIVELY A FUNCTION OF THE PUBLIC HEALTH SERVICE AND ARE REQUIRED BY STATUTE TO BE FURNISHED SEAMEN EMPLOYEES REGARDLESS OF THE FACT THAT THE BENEFICIARIES OF SUCH SERVICES MAY BE EMPLOYEES OF THE PANAMA CANAL COMPANY. ACCORDINGLY, IN ANSWER TO QUESTION 1, IT MAY BE STATED THAT EMPLOYEES OF THE PANAMA CANAL COMPANY FALLING WITHIN THE PREVIEW OF SECTION 322 (A) OF THE PUBLIC HEALTH SERVICE ACT ARE ENTITLED TO THE MEDICAL AND RELATED SERVICES PROVIDED THEREIN AND THERE IS NO REQUIREMENT THAT THE COMPANY REIMBURSE THE PUBLIC HEALTH SERVICE FOR SUCH SERVICES.

WITH RESPECT TO THE SECOND QUESTION, THE EVIDENT PURPOSE OF SECTION 106 OF THE CIVIL FUNCTIONS APPROPRIATION ACT, 1954, IS NOT TO DEPRIVE ANY SEAMAN OF THE BENEFITS CONFERRED BY THE PUBLIC HEALTH SERVICE ACT. THAT CONNECTION, IT IS STATED IN REPORT NO. 450, HOUSE OF REPRESENTATIVES, 83D CONGRESS, ST SESSION, PAGE 13, AS FOLLOWS:

FREE MEDICAL CARE AND HOSPITALIZATION ARE BUT TWO OF THE SEVERAL EMOLUMENTS AVAILABLE TO EMPLOYEES OF THE COMPANY AND THE CANAL ZONE GOVERNMENT. EXECUTIVE ORDER NO. 1888, FEBRUARY 2, 1914 (AS AMENDED) IS THE BASIS FOR THESE FREE MEDICAL SERVICES. THE PERTINENT SECTION OF THE ORDER READS:

" ALL EMPLOYEES IN CASES OF ILLNESS OR INJURY WILL RECEIVE FREE MEDICAL CARE AND ATTENDANCE IN THE HOSPITALS. IF MEDICAL ATTENDANCE IS FURNISHED IN QUARTERS, A CHARGE MAY BE MADE UNDER REGULATIONS TO BE PRESCRIBED BY THE GOVERNOR. EMPLOYEES SHALL BE CHARGED FOR MEDICAL CARE AND ATTENDANCE FURNISHED MEMBERS OF THEIR FAMILIES AT THE HOSPITALS AND AT THEIR QUARTERS AT SUCH RATES AND UNDER SUCH REGULATIONS AS MAY BE PRESCRIBED BY THE GOVERNOR.'

WHILE THE TROPICAL CLIMATE OF THE ZONE MAY NOT PROVIDE THE MOST HEALTHFUL WORKING CONDITIONS, THE TREAT OF YELLOW FEVER AND OTHER TROPICAL DISEASES THAT PROMPTED ISSUANCE OF THE ORDER IN 1914 HAS BEEN REMOVED. WORKING CONDITIONS OF COURSE, ARE NEVER IDEAL IN THE TROPICS AND A LARGER DEGREE OF MEDICAL CARE IS UNDOUBTEDLY REQUIRED. TO THIS EXTENT THE GOVERNMENT IS PERHAPS NOT AMISS IN PROVIDING SOME MEDICAL SUBSIDY, BUT NOT TO THE PRESENT EXTREME. ACCORDINGLY, LANGUAGE IS CONTAINED IN THE ACCOMPANYING BILL REVOKING THE PRESENT FREE MEDICAL SERVICE POLICY OF THE COMPANY. THE COMMITTEE WILL EXPECT NEW MEDICAL TARIFFS TO BE PROMULGATED AT ONCE TO MORE PROPERLY REFLECT THE COSTS OF SUCH SERVICES AS WELL AS THE ABILITY OF THE EMPLOYEES CONCERNED TO BEAR THESE COSTS.

IT IS REASONABLY CLEAR FROM THE FOREGOING THAT THE PROHIBITION OF SECTION 106 IS DIRECTED TOWARD THE FREE MEDICAL CARE AND HOSPITALIZATION HERETOFORE PROVIDED ALL EMPLOYEES OF THE PANAMA CANAL COMPANY AND THE CANAL ZONE GOVERNMENT BY THE ABOVE REFERRED-TO EXECUTIVE ORDER BECAUSE OF THE ONE TIME PREVALENCE OF TROPICAL DISEASES IN THE ENVIRONMENT IN WHICH SUCH EMPLOYEES WORKED AND NOT BECAUSE ANY SUCH EMPLOYEES WERE ENGAGED AS SEAMEN.